Florida Senate - 2009 CS for CS for SB 1180
By the Committees on Governmental Oversight and Accountability;
and Children, Families, and Elder Affairs; and Senators Wise and
Dockery
585-05348-09 20091180c2
1 A bill to be entitled
2 An act relating to forensic mental health policy;
3 providing for the creation of a workgroup to review
4 state policy and budgeting issues affecting adults
5 with serious mental illness who also have involvement
6 with the state criminal justice system; providing for
7 administrative and assistance; providing for
8 membership, organization, and meetings; specifying
9 that members serve without compensation, but are
10 reimbursed for expenses; specifying components of the
11 review; authorizing use of outside research
12 organizations; providing for interim and final
13 reports; providing for future termination of the
14 workgroup and expiration of the provisions creating
15 it; providing an effective date.
16
17 Be It Enacted by the Legislature of the State of Florida:
18
19 Section 1. (1) There is created a workgroup to review state
20 policy and budgeting issues affecting adults with serious mental
21 illness who also have involvement with the state criminal
22 justice system. The Secretary of Children and Family Services,
23 in conjunction with the Secretary of Corrections and the
24 Secretary of Health Care Administration, shall provide staff and
25 other administrative assistance to the workgroup.
26 (2) The workgroup shall consist of the following members:
27 (a) One member from the Substance Abuse and Mental Health
28 Corporation.
29 (b) One member appointed by Florida Legal Services, Inc.
30 (c) One member appointed by the Florida Psychiatric
31 Society.
32 (d) One member appointed by the Correctional Medical
33 Authority.
34 (e) One member appointed by the Florida Prosecuting
35 Attorneys Association.
36 (f) One member appointed by the Florida Public Defender
37 Association.
38 (g) One member appointed by the Florida Association of
39 Court Clerks.
40 (h) One member appointed by the Florida Assisted Living
41 Affiliation.
42 (i) One member appointed by the Florida Council for
43 Community Mental Health.
44 (j) One member appointed by the Department of Children and
45 Family Services.
46 (k) One member appointed by the Agency for Health Care
47 Administration.
48 (l) One member appointed by the Department of Corrections.
49 (m) One member appointed by the Florida Sheriffs
50 Association.
51 (n) One member appointed by the Florida Police Benevolent
52 Association.
53 (o) One member appointed by the Florida chapter of the
54 National Alliance for the Mentally Ill.
55 (p) One member appointed by the Florida Hospital
56 Association representing private receiving facilities.
57 (q) One member appointed by the Florida Psychological
58 Association.
59 (r) One member appointed by the President of the Senate.
60 (s) One member appointed by the Speaker of the House of
61 Representatives.
62 (t) One member appointed by the Governor.
63 (3) Members of the workgroup shall serve without
64 compensation for such service. However, each member is entitled
65 to reimbursement from the member’s appointing entity for per
66 diem and travel expenses as provided in s. 112.061, Florida
67 Statutes.
68 (4) Each meeting of the workgroup shall be held in
69 Tallahassee at the offices of the Department of Children and
70 Family Services. The workgroup shall meet four times per year
71 and may use electronic means of communication, which may
72 include, but are not limited to, conference calls, webinars, and
73 video conferencing.
74 (5) The workgroup shall organize and conduct its meetings
75 in accordance with Robert’s Rules of Order.
76 (6) The workgroup may request the Louis de la Parte Florida
77 Mental Health Institute at the University of South Florida to
78 conduct research or analysis of data projects identified by the
79 chair and the members, within existing contractual agreements
80 with the Department of Children and Family Services.
81 (7) The review conducted by the workgroup under this
82 section must include:
83 (a) The identification of all state funds being expended on
84 the care of adults with mental illnesses who have legal
85 involvement with state and county courts, including funds
86 expended on care in correctional facilities and funds expended
87 on medication, courts, attorneys, state institutions, contracts
88 with private institutions, community-based programs, Medicaid
89 services, state-funded substance abuse services, state-funded
90 mental health services, and managed care plans.
91 (b) A detailed examination of community-based service
92 delivery systems, including utilization issues, housing issues,
93 psychiatric emergency crisis response outcomes, effective
94 practices, and programs directed toward individuals who are at
95 risk for court or legal involvement.
96 (c) A detailed review of data, utilization, and cost
97 analysis for individuals who are involved with the county
98 courts, state courts, state prisons, and state and private
99 institutions, have been charged with misdemeanors or felonies,
100 and have a diagnosis of serious and persistent mental illness.
101 (d) A detailed review of utilization data and costs for
102 individuals who have traumatic brain injuries, have involvement
103 with state courts, state prisons, county courts, or county
104 jails, and have involvement with state-funded substance abuse
105 and mental health services.
106 (e) A review of the role and costs of early discharge and
107 inappropriate placement on the use of state prisons and county
108 jails from public crisis-stabilization units, community
109 inpatient psychiatric hospitals, and state and private
110 institutions that care for persons with serious and persistent
111 mental illness.
112 (f) A review of the criminal code, including penalties and
113 sentencing guidelines, and other laws pertaining to the forensic
114 mentally ill in order to assess where changes could be made that
115 protect public safety while ensuring that the needs of the
116 mentally ill are met in a cost-effective manner, with a goal to
117 create a plan that will reduce reliance on state prisons and
118 county jails.
119 (g) The identification of programs, practices, and
120 innovative solutions emerging in the state which would reduce
121 the need for incarceration, improve cost-effectiveness, and help
122 reduce the impact on the state budget and improve public safety.
123 (h) A process for requesting and reviewing innovative
124 proposals that would help the state optimize the use of state
125 funding by examining the use of special pilot projects, mental
126 health courts, changes in emergency psychiatric care, new
127 approaches to law enforcement practices and court diversion
128 programs, and the use of modified sentencing or waivers relative
129 to the criminal code.
130 (i) The development, in conjunction with the Agency for
131 Health Care Administration, of a proposal for legislative
132 consideration which would establish an innovative Medicaid
133 waiver that would help support stable housing and services for
134 those individuals defined as at risk of court-related
135 involvement. For the purposes of this subsection, the term “at
136 risk of court-related involvement” means a person who has been
137 charged with a misdemeanor or felony and diagnosed with a
138 serious and persistent mental illness.
139 (j) A review of the effect of substance abuse on the system
140 and methods to create integration and the use of Medicaid
141 waivers, such as the Medicaid 1915c Home and Community-Based
142 Waiver, to provide a more integrated approach to treating
143 substance abuse in the community.
144 (k) The use of involuntary outpatient commitment
145 requirements under the Baker Act and the need for changes to
146 those requirements which would help reduce or mitigate the
147 potential for court involvement in this process. This review
148 shall include the use of the Florida Medication Algorithm
149 Project and its implications for improved outcomes relative to
150 individuals at risk of court-related involvement.
151 (l) A review of the current status of the use of electronic
152 medical records, the need for broader use of electronic medical
153 records for individuals at risk of court involvement, and the
154 fiscal impact in terms of the savings that this type of client
155 information system would have on reducing state expenditures and
156 improving access to care for those considered most at risk. The
157 workgroup may request experts in the field to make presentations
158 and respond to questions. The workgroup shall make
159 recommendations as provided in subsection (9).
160 (m) A review and comparison of the practices and standards
161 used in correctional facilities to provide mental health care
162 for individuals who are incarcerated in county jails, state
163 prisons, or state or private state mental health forensic
164 institutions.
165 (n) The consideration of plans and recommendations
166 concerning appropriate methods of diverting mentally ill inmates
167 to less restrictive and less expensive alternatives using
168 conditional release or probation.
169 (o) A review of probation and parole requirements for
170 recommended modifications in order to assist with improving
171 community placement and community control for persons with
172 serious and persistent mental illnesses who are eligible for
173 probation. This shall include a review of rules and policies and
174 recommendations.
175 (p) A review of practices associated with the discharge of
176 individuals with a serious mental illness from the Department of
177 Corrections and from state-operated and state-funded forensic
178 mental health institutions for compliance with interagency
179 agreements regarding placement in the community, recidivism to a
180 jail or institutional setting, and utilization of hospital
181 emergency rooms, involuntary commitment services, and crisis
182 stabilization units.
183 (8) The Department of Children and Family Services, the
184 Department of Corrections, and the Agency for Health Care
185 Administration may use outside research organizations to help
186 collect information for the workgroup to use in assessing the
187 factors contributing to the rise in the numbers of adults with
188 serious mental illness in the criminal justice system.
189 (9) The workgroup shall make recommendations in its interim
190 and final reports regarding proposed changes to the state penal
191 code, sentencing guidelines, state mental health policy, and
192 related strategies which would improve public safety through
193 better integration of behavioral health care at all levels of
194 the criminal justice system, with a goal of reducing reliance on
195 county jails and state prisons. The workgroup shall submit an
196 interim report with findings and recommendations to the
197 President of the Senate, the Speaker of the House of
198 Representatives, and the Governor by January 5, 2010, and its
199 final report with recommendations and findings by January 5,
200 2011.
201 (10) The workgroup terminates and this section expires July
202 1, 2011.
203 Section 2. This act shall take effect July 1, 2009.